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Detection of Brain Swelling

Brain swelling is a potentially lethal complication of acute brain injuries. Current methods of detecting brain swelling are invasive, or may identify its progression too late to reverse further damage. Dr. Charlene Ong of Harvard University will test whether an innovative handheld technology that measures pupil changes can improve the diagnosis and treatment of brain swelling. Her findings could save lives and improve quality of life for those who suffer from sudden and catastrophic brain injuries.

Project Description

Brain Swelling After Injury:
Brain injuries such as stroke, intracranial hemorrhage (internal bleeding in the brain), and trauma can be deadly and debilitating for the 1.8 million Americans affected each year. Without appropriate treatment, major swelling can cause death in up to 60-80% of patients after large strokes, and significantly complicates the treatment of patients with traumatic brain injury and intracranial hemorrhage. Those who are fortunate enough to survive both the initial injury and swelling afterward may still face significant mental and physical disability. By diagnosing and treating brain swelling as early as possible, quality of life could be greatly improved for these patients.

What We Know:
In patients at risk for brain swelling, a change in pupil symmetry (when one pupil becomes significantly larger than the other) can signify a potentially lethal swelling event. However, this change in pupil size happens only after considerable swelling has occurred, and when treatment may no longer be effective. Other methods to closely monitor brain pressure, such as intracranial monitors, are invasive and may not be widely accessible to all medical centers.

Our Plan to Help:
Dr. Charlene Ong, at Harvard University Hospitals Massachusetts General and Brigham and Women’s, hopes to find a safe and effective method to catch signs of brain swelling earlier. She will use a handheld device, called a pupillometer, which can accurately and non-invasively detect subtle changes that a doctor or nurse may not catch on his or her own until it is too late. Dr. Ong will study whether small changes in pupil size and reactivity can detect brain swelling after an injury, and whether they can be used to measure the efficacy of drugs that reduce brain swelling. If successful, this new technology could have immediate implications for the management of patients with these brain diseases.

Thanks to the help of donors, Dr. Ong has received over $8,200 to conduct her research. Please check back for updates on her project. Donations are no longer being accepted at this time to support Dr. Ong's project.

Updates

Over the year of the funded grant, we collected pupil measurements in over 300 patients, and have over 15,000 pupil measurement recordings.

We went on to publish two manuscripts in Neurocritical Care, describing our findings that pupil
reactivity improves after therapy used to combat elevated intracranial pressure, and how
ambient lighting conditions may affect pupil readings.

We will continue to use the data in our deeper analyses of intracranial pressure and pupil reactivity, as well as radiographic markers of midbrain compression and pupil reactivity. This work has provided the foundational and preliminary data to support an NIH proposal submission in June of 2019, and further data collection is being conducted at the PIs new institution at Boston Medical Center.

Thank you for the opportunity the American Brain Foundation provided by selecting this study
as one of its debuts for crowd-sourcing seed funding.